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Posts for: December, 2017

By Paul David Epstein, D.M.D. & Associates, P.C.
December 20, 2017
Category: Oral Health
Tags: tooth decay  
LessisBetterthe21stCenturyApproachtoToothDecayTreatment

For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.

Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.

It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.

Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.

We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.

Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.

Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.

If you would like more information on minimally invasive dentistry, please contact us or schedule an appointment for a consultation.


By Paul David Epstein, D.M.D. & Associates, P.C.
December 05, 2017
Category: Oral Health
Tags: tooth pain  
TheDetailsAboutYourToothSensitivityPaincantellyouaLotAbouttheCause

Tooth sensitivity can be quite uncomfortable. But the glancing pain you feel may be more than an irritation — it may also be telling you there’s a deeper problem that needs attention.

As with other types of oral pain, tooth sensitivity can be a symptom for a variety of problems. Some of them are relatively minor, while others require immediate attention. It’s important to pay attention to the details about your tooth sensitivity and what they might be indicating you should do about it.

For example, your teeth may be sensitive to hot or cold foods or beverages. If it’s just a momentary pain it generally doesn’t mean an emergency — it could be a small area of decay on a tooth, a loose filling or an exposed root due to gum recession or overaggressive brushing. Besides seeing us for treatment for any decay, you can adjust your brushing habits to more gentle pressure with a soft-bristled brush. Fluoride toothpaste has also been shown to reduce this kind of sensitivity.

If, however, the pain from hot or cold substances lingers, then decay or some form of trauma may have affected the pulp, the innermost layer of a tooth. The pulp is rich in nerve fibers and can become inflamed and irritated from the decay or injury. You should visit us as soon as possible: you may require a root canal treatment that will not only relieve the pain but also save the tooth.

If you notice a sharp pain when biting down on food, it’s possible you have a loose filling or even a cracked tooth. As with inner decay, a fracture requires immediate attention. A loose filling should be easy to repair, but if it’s a fracture you may need extensive treatment to save the tooth or, if beyond salvage, have the tooth removed to make way for dental implant or similar restoration.

The key point is not to delay seeking treatment, especially if the pain is persistent, severe or long-lasting. The sooner you visit us about your tooth sensitivity, the sooner you’ll have solutions to stop the discomfort.

If you would like more information on tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Pain? Don’t Wait!